The United States Department of Justice (DOJ) Fraud Division named home health and hospice as among its top enforcement priorities and plans to use innovative data analysis to target fraud schemes in these industries, according to a Thursday memorandum.
The agency plans to further crack down on healthcare fraud by increasing the headcount of its Health Care Fraud Strike Force model to about 500 attorneys and staff by Aug. 24.
“Home health aide and hospice scams directly impact vulnerable elderly Americans and erode patient care,” Assistant Attorney General Colin M. McDonald wrote in the memo. “Kickbacks and companies that cut corners to deceive regulators about the nature of health care services or products deny patients the ability to make informed health care decisions and degrade the dignity of American consumers.”
The DOJ Fraud Division will also target telemedicine programs, Medicare or Medicaid fraud, controlled substance diversion and deceptive marketing for unsafe products and services within its fraud enforcement initiatives.
Earlier this month, the DOJ Fraud Division charged 19 individuals in fraudulent Medicare and Medicaid schemes totaling $4 million, in which the defendants allegedly submitted claims for nonexistent care or billed an impossibly large number of hours.
The DOJ announcement of a bolstered Fraud Division comes after the CMS implemented six-month moratoria on new home health and hospice Medicare providers enrollments effective May 13 to cut down on fraud, waste and abuse.
“We’ve seen systemic and deeply troubling fraud in the hospice and home health space, with bad actors exploiting some of our most vulnerable Medicare patients and stealing money from the American taxpayer,” Home Health Care News reported CMS Administrator Dr. Mehmet Oz as saying. “Today we’re shutting the door on fraud — preventing new bad actors from entering Medicare while we aggressively identify, investigate and remove those already exploiting them.”
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